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Pap smear screening for small cell carcinoma of the uterine cervix: a case series and review of the literature

 Hyun Jong Park  ;  Young Mi Choi  ;  Chan Kyung Chung  ;  San Hui Lee  ;  Ga Won Yim  ;  Sang Wun Kim  ;  Eun Ji Nam  ;  Young Tae Kim 
 JOURNAL OF GYNECOLOGIC ONCOLOGY, Vol.22(1) : 39-43, 2011 
Journal Title
Issue Date
Ambulatory CareMark ; Carcinoma, Small CellMark ; Cervix UteriMark ; Early DiagnosisMark ; FemaleMark ; GynecologyMark ; HumansMark ; Mass ScreeningMark ; ObstetricsMark ; RecurrenceMark ; Retrospective StudiesMark ; Stress, PsychologicalMark ; Survival RateMark ; Uterine Hemorrhage
Low prevalence ; Papsmear ; Recurrence ; Smallcellcarcinoma ; Survival rate ; Uterinecervix
OBJECTIVE: Small cell carcinoma of the uterine cervix (SMCC) is extremely rare, and an aggressive disease that proliferates rapidly. It was often reported that the diagnostic accuracy of cytologic smears in diagnosing SMCC was low. This is a report of the Severance Hospital experience with the patients suffering from SMCC.

METHODS: Twenty-seven patients with small cell carcinoma of the uterine cervix were diagnosed and treated at the Severance Hospital from November 1991 to January 2010. The data were analyzed retrospectively, based on the available charts and pathology reports. Various fields, such as chief complaints and symptoms present at first clinic visit, age, International Federation of Obstetrics and Gynecology (FIGO) clinical stage, treatment modality, the 5-year overall survival rate, and recurrence rate were investigated.

RESULTS: Among the 27 patients diagnosed with small cell carcinoma of the uterine cervix, 18 of them (66.7%) presented with symptoms, including vaginal bleeding, at the first clinic visit, and the remaining 9 patients (33.3%) showed abnormal Pap smear screening in the process of their routine health check-up. The median age of the patients was 54 years (range, 24 to 77 years). FIGO stage IIB was the most common stage (11 of 27 patients). The 5-year overall survival rate of 21 patients, who could be followed up, was 57.2%. Six patients showed recurrence after remission, and the mean disease free interval of them was 9.2 months (range, 6 to 11 months). Abnormal Pap smear screening results of 9 patients was investigated, and the diagnostic accuracy of the cytologic findings was 22.2%.

CONCLUSION: Our study was consistent with the concept that Pap smear screening might not be helpful in early diagnosis of SMCC considering its low diagnostic accuracy. Further large-scale multicenter prospective studies are definitely needed in order to produce abundant information about optimal therapy and diagnosis.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Nam, Eun Ji(남은지) ORCID logo https://orcid.org/0000-0003-0189-3560
Park, Hyun Jong(박현종)
Lee, San Hui(이산희)
Yim, Ga Won(임가원)
Choi, Young Mi(최영미)
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